Hearing

[frankhond]

I think we can agree that, irregardless of bodypart/function, there is nothing currently that replaces it fully... although some technical solutions provide very good alternatives, at least for a time.

My hearing aids are from Resound and a couple year ago they were top of the line. They have lots of confusing models and model numbers but this is the then new generation where the battery lasts 2-3 weeks instead of a couple days. Next time I'll go for rechargeables if they come down in size.

Pricing in EU is different from the US, many manufacturers make volume deals with the state and can't charge fantasy prices. Some countries provide further subsidies. In dollars my price was about $1500 which was subsidized to around $1100. As a comparison, Starkey doesn't have a deal and charges around $4000 for a comparable pair. Siemens was like $2500. I discussed the differences with the audiologist, he said Siemens had a bit more detail in the high frequencies, but my hearing is almost completely gone there so it wouldn't give any benefit. He used to work for Starkey and said they didn't do anything significantly better to warrant the price.

The audiologist was a musician and sound engineer. He put in stronger amplifiers to maximize dynamic range. For a more natural guitar sound we experimented with open/semi-open domes - the open ones give the most natural acoustic guitar sound, but the semi-open ones give a push in midrange that give a lot more meat to the overall aural environment. About a year ago I switched to semi-open which gives a better experience in all cases except acoustic guitar playing.

In the end it's like buying speakers.... you need to find a really good pro that can advise you based on your situation, not which company pays the provision. And I really recommend getting a pair even if you have only moderate hearing loss. For one, life becomes more interesting, you suddenly hear in a new way. Two, it costs energy to try hearing and understanding what people are say. And three, there are some fun side effects, in a café I can hear perfectly what people say across the room (better than the people I'm with).

[RJVB]

Yes there are. Cochlear implants have been in common use for 20+ year.

I was not aware of this but

Many users of modern implants gain reasonable to good hearing and speech perception skills post-implantation, especially when combined with lipreading. One of the challenges that remain with these implants is that hearing and speech understanding skills after implantation show a wide range of variation across individual implant users. Factors such as age of implantation, parental involvement and education level, duration and cause of hearing loss, how the implant is situated in the cochlea, the overall health of the cochlear nerve, but also individual capabilities of re-learning are considered to contribute to this variation.

Still seems that a good dental implant will be a lot more useful. I have one, and am quite confident that the titanium core (the actual implant) will survive anything I can try to do to it, esp. since I've learned to control my chewing force to protect my real teeth. If the crown breaks ... too bad, I'll have to pay for a new one, but the actual replacing is easier than replacing a car tyre. But it's clearly much more solid than the ceramics used for fillings (I miss the old amalgams for that) or even for inlays and crowns installed over real teeth. Then again, those have become a lot less expensive recently; even in my ~2000 souls village we have a dental practice that has a CNC machine with special scanner to make inlays and crowns.

[nevershouldhavesoldit]

Still seems that a good dental implant will be a lot more useful. I have one, and am quite confident that the titanium core (the actual implant) will survive anything I can try to do to it.

The roots of natural teeth do not sit in bone like a peg in a board. They’re surrounded by a complex structure called the periodontal membrane or ligament (although it’s neither a membrane nor a ligament). It’s an elegant interwoven system of microscopic blood vessels and strong, somewhat elastic fibers anchored in the cementum (outer layer of the root) and in the surrounding bone and its covering layer. The fibers are angled much the same way boats are secured to a dock, so that they dissipate the forces of chewing efficiently and allow slight, well damped movement of teeth in their sockets.

If you put pressure on bone, it will reabsorb ahead of that pressure. As long as the periosteum (natural cover of bone, with cells in it that can make more) is intact, new bone forms behind the area under pressure. This is how and why braces work to move teeth. Plain implants (which are usually blades or posts) sit in bone with no ability to dissipate forces applied to them and no periosteum lining the hole into which they’re placed. They eventually loosen, become infected, and are lost.

Modern implants are coated with materials and/or surface-treated to enhance “osseointegration”, ie encouraging ingrowth of bone, to strengthen the bond. Some of the best ones are hollow and have perforations for better integration. With good care, they can last many years. But they still have nothing like the perio membrane to dissipate the destructive forces of ordinary use. Fortunately, bone itself is slightly elastic, and extensive osseointegration lets the bone itself help dissipate force. And with no periosteum between the bone and the implant, absorption and re-deposition of surrounding bone are less of a problem. But no implant is as resistant to the forces of mastication as a sound natural tooth.

We can generate pressures up to 10k PSI between our molars, which puts intermittent forces of hundreds of pounds on our back teeth. It’s a jungle in there!

[RJVB]

TSome of the best ones are hollow and have perforations for better integration. With good care, they can last many years.

Mine was installed in 2012, by a dentist specialising in this (in fact, the operation was done "in class" with a small audience of dentists who already worked in practice). It amused me the realise how he used a tiny dynamometric wrench to screw the implant into the bone (freshly formed where a cyst had made me lose a very well done crown). Because of that I had regular radios taken up to a few years ago, which always showed a perfect implant. I'll remember to have one done again next time I go in.

I didn't get any special care instructions, though

We can generate pressures up to 10k PSI between our molars, which puts intermittent forces of hundreds of pounds on our back teeth. It’s a jungle in there!

I know, and I used to use that force. I wasn't even 25 when I was told that my teeth were worn like those of a 50 yo (and until that age I rarely ever had caries). I've broken cherry and even olive seeds -inadvertently- but nowadays I fear losing a bit of real tooth, inlay or filling eating the kind of things many wouldn't associate with tooth danger (country bread, dried sausage, ...)

[Woody Sound]

I'm getting this problem where in a large noisy room, I can hear everyone in detail, but not the person directly across from me conversing.

[nevershouldhavesoldit]

I didn't get any special care instructions, though

You just need to be meticulous about oral hygiene. Once you develop a periodontal problem under an implant-borne crown, or reach incipient implant failure as evidenced by loosening, discomfort, drainage (often noticed first as an intermittent foul or unusual taste), that implant is probably not going to survive. Many prosthodontists recommend tiny brushes, small irrigation tips etc for cleaning under the prosthetic teeth.

Single implants tend to do fine with aggressive brushing, flossing (water and string), etc. This part of the thread began with someone’s implication that implants can truly restore a lost dentition somewhere close to full functionality, and that’s not true. Just as hearing aids cannot restore full natural hearing, full arch fixed restoration built on implants cannot recreate a normal dentition and is no substitute for maintaining and keeping our natural teeth. Asking a few abutments to dissipate the loads intended for 28 to 32 is simply unrealistic. Many implant-borne full restorations are actually removable dentures that slip over a few specially made coping crowns affixed to implants. But these look and feel like ordinary dentures - they’re just more stable.

Your experience with a single implant is typical and great to hear about! But if anything, your lifetime dental experience should motivate you to do everything in your power to minimize the future need for more.

[nevershouldhavesoldit]

I didn't get any special care instructions, though

You just need to be meticulous about oral hygiene. Once you develop a periodontal problem under an implant-borne crown, or reach incipient implant failure as evidenced by loosening, discomfort, drainage (often noticed first as an intermittent foul or unusual taste), that implant is probably not going to survive. Many prosthodontists recommend tiny brushes, small irrigation tips etc for cleaning under the prosthetic teeth.

Single implants tend to do fine with aggressive brushing, flossing (water and string), etc. This part of the thread began with someone’s implication that implants can truly restore a lost dentition somewhere close to full functionality, and that’s not true. Just as hearing aids cannot restore full natural hearing, full arch fixed restoration built on implants cannot recreate a normal dentition and is no substitute for maintaining and keeping our natural teeth. Asking a few abutments to dissipate the loads intended for 28 to 32 is simply unrealistic. Many implant-borne full restorations are actually removable dentures that slip over a few specially made coping crowns affixed to implants. But these look and feel like ordinary dentures - they’re just more stable.

Your experience with a single implant is typical and great to hear about! But if anything, your lifetime dental experience should motivate you to do everything in your power to minimize the future need for more.

[RJVB]

if anything, your lifetime dental experience should motivate you to do everything in your power to minimize the future need for more.

Something like that, for financial reasons more than my experience (without becoming as OCD about it as I'm about protecting my hearing...). But I know certain things run in the family without much hope of avoiding them.

[nevershouldhavesoldit]

But I know certain things run in the family without much hope of avoiding them.

Apart from rare congenital disorders like osteogenesis imperfecta, the only thing hereditary about dental disease and premature tooth loss is the simple fact that we first learn how to take care of our teeth from our parents. The commonest causes of adult tooth loss are less-than-excellent oral hygiene / care and decay / premature loss of deciduous teeth. It's amazingly common among even the most educated and affluent to believe that because "baby teeth" are lost and replaced, they don't matter as much as adult teeth. In truth, they maintain space for their adult successors, and diseased baby teeth can directly affect the integrity and longevity of the developing adult teeth below them.

Losing one's teeth and hearing is absolutely not inevitable with aging. Poor hearing and oral health among older populations are very common - but they are definitely not normal.

[Vladan]

I'm getting this problem where in a large noisy room, I can hear everyone in detail, but not the person directly across from me conversing.

Same with me. I think it could be indication of hearing loss.

Another empirical curiosity, I do not know if it means anything. In a noisy club, or on a rock gig, if someone is talking to me, I can better hear and understand if they talk at normal speech level, or even below it, then shouting in my ear trying to overpower the PA.

[RJVB]

Another empirical curiosity, I do not know if it means anything. In a noisy club, or on a rock gig, if someone is talking to me, I can better hear and understand if they talk at normal speech level, or even below it, then shouting in my ear trying to overpower the PA.

I think there must be an explanation in the frequency content, and the fact our auditory system is optimised around frequencies of normal speech (not just the sensory part, also the central treatment).

This doesn't work of course when the background noise has too much energy in those same frequency bands.

[mheton]

Hello, its my first post here ...

Does anyone have experiences with tinnitus and hearing aids?
I assume the volume of the tinnitus will remain the same, but what is the subjective feeling like with a hearing aid?
Is it better to start wearing hearing aids earlier to get used to the processing of auditory data?

[EastwoodMike]

Mid 40’s here. No dental issues. No significant hearing loss other than age and apparently some quiet high end that my wife can still hear.
timely post as I was starting to wonder about volume during ensemble next to a sax and opposite a drummer.
I only yesterday bought a set of earplugs for myself and my Son. (Alpine party plugs) to get in ahead of any further loss. Wore them today through my daughters dance troupe concert. Quite comfortable and virtually invisible when worn.
I am yet to consider a mouthguard though.
Emike

[whiskey02]

The best place to get good quality hearing aids is Costco. Five or six years ago I paid $60 to join; as a member you can schedule a cost free hearing test with an Audiologist. If you would benefit from aids, the kind/ brand that you need are matched to that data from that test. That is, not all hearing loss is the same. Most common can be helped with their house brand Kirkland hearing aids. I paid $1600 5 or 6 years ago, but the price has decreased since then. When you speak with someone who has paid the more typical $ 5-6 K they don't believe you can get aids for that low price. They are very good quality and work very well. Some of them a bit combative about it.
The aids are " custom programmed" to your hearing. After using them for a while you see the audiologist again and report your experience so if your left ear is getting too little or too much high frequency or not enough volume, they can tweak them right there. Go home and come back after the adjustment. You can do this as many times as needed with no additional cost. They also come with a 2 year warranty Which includes replacement if you damage or lose them. My cousin left his in a foreign hotel.
My problem is high frequency loss (word recognition) not really do much volume, I don't need them to listen or play music. There are multiple settings that can be switched to like a loud crowded room, music listening and playing an instrument. I have tried the playing guitar and find a terrible chorusing effect as you hear the signal from your guitar followed a millisecond later by the signal from the aids. It might be very different if you actually NEED help hearing your guitar. Feel free to shoot me any questions you have.

Decent hearing instruments are not cheap - 6k$ in my case - but they are well worth it. Modern designs can be pin-point focused on frequency loss, and custom-fitted (tonally and physically) to your individual needs. Don't wait - you don't know what you are missing until it is (even partially) restored. What good is a fine guitar if you can't hear its full glory?

[citizenk74]

Same with me. I think it could be indication of hearing loss.

Another empirical curiosity, I do not know if it means anything. In a noisy club, or on a rock gig, if someone is talking to me, I can better hear and understand if they talk at normal speech level, or even below it, then shouting in my ear trying to overpower the PA.

You may be unconsciously lip reading. I know I was, pre-pandemic. It became more conscious as my hearing worsened.

[Vladan]

I think there must be an explanation in the frequency content, and the fact our auditory system is optimised around frequencies of normal speech (not just the sensory part, also the central treatment).

This doesn't work of course when the background noise has too much energy in those same frequency bands.

You may be unconsciously lip reading. I know I was, pre-pandemic. It became more conscious as my hearing worsened.

Frequency range - possibly.
Lip reading - no.

Maybe I was not precise enough. It was just tangential on post about not being able do hear directionally and willingly isolate specific sounds from the crowd noise.
I do not think it is related to hearing loss.
What I meant ... I can hear them shouting, right into my ear, but not as intelligible speech.

IMO, it is about too much volume/ sound pressure. Ear drums can not move that much, effectively compressing. Over compression equals distortion, therefore reduced intelligibility.
So I say, ... please repeat that, but without yelling ...
The effect is kind of analogue to that test for colour blindness, where you see a specific shape (number) within a pattern of similarly colouredred dots.

[Vladan]

... It, like an air bubble of intelligible quiet speech within ocean of PA noise ...

[Vladan]

... or, to bring get rid of visual analogies, like in radio broadcast, signal modulating broadband noise ...

[nevershouldhavesoldit]

I do not think it is related to hearing loss. What I meant ... I can hear them shouting, right into my ear, but not as intelligible speech.

Hearing is not a simple matter of sensitivity. There are many testable parameters of hearing, the most important of which are

• threshold sensitivity - the quietest sound you can detect at a given frequency
• maximum comfortable loudness level (MCL) - the loudest SPL you can tolerate without difficulty
• speech recognition threshold (SRT) - the lowest SPL at which you can identify that you are hearing 2 syllable words
• speech discrimination - the ability to understand spoken speech delivered at a level 30 dB above the SRT as measured by your ability to accurately repeat words spoken to you

Routine audiometry determines threshold sensitivity at octave intervals from 256 Hz to 8k. This does not measure your ability to hear real world sounds across the frequency spectrum - it only measures your threshold of detection of the presence of sound at the test frequency. The phenomenon of recruitment describes dynamic range compression and means that you may have significant impairment of threshold sensitivity but still be able to hear louder sounds normally. So you may have a normal maximum comfortable loudness level above an elevated sensitivity threshold, which is by definition a narrowed dynamic range of hearing. And you may have normal or mildly impaired threshold sensitivity but still be unable to understand speech at levels you can easily hear.

If you have impaired speech discrimination even at SPLs well above your sensitivity thresholds, you may have central auditory processing problems. This is a fairly common cause of functional hearing loss with which you can tell that someone is speaking to you, but you have trouble understanding what they're saying. It's central in that it results from problems in your brain's auditory pathways rather than your middle or inner ear (which cause peripheral auditory problems). If you have central auditory processing problems, hearing aids will not help because they only make things louder - it's your brain that's having trouble processing the sound and allowing you to make meaningful use of it.

While it's tempting to simplify hearing into an on-off phenomenon, it's much more complicated than that. The routine hearing tests most people consider definitive are just a screening battery - and doing it online through uncalibrated devices in an environment that's not acoustically isolated is only a crude screening test. It takes a lot of sophisticated and intensive testing to even begin to sort out some of the complex hearing problems that plague us. Sadly, most audiologists and otologists do not understand the needs and problems of musicians. If you have problems hearing, and especially if they affect your playing and performance, you need to seek out an otologic physician or a sophisticated audiologist with the knowledge, skill, experience, equipment and interest to take our needs seriously and approach them scientifically.

[Vladan]

Yes, It is complex.
MCL and recruitment ... brain damage and personality (character) ... and what not ...

[Woody Sound]

This company does heavy advertising in my area. I am in no way endorsing them and have not had any contact with them, it just makes for interesting browsing.

Improve Your Life With Better Hearing | Hearing Aids | Audiology | Buffalo, NY

[nevershouldhavesoldit]

Yes, It is complex. MCL and recruitment ... brain damage and personality (character) ... and what not ...

Hearing is as essential to a guitarist as strings. Yet many pay far more attention to the latter. There are many kinds and causes of hearing loss. Some are treatable, some are reversible, and some have no known remedies. There are medical, pharmaceutical, toxic and genetic causes in addition to the simple ravages of environmental noise and the occasional knock on the head.

Hearing aids are just tiny sound reinforcement systems. The most sophisticated have serious EQ and are now even getting into reshaping the waveforms. This is all helpful to a lot of people with a few different kinds of loss. But the first part of a proper hearing evaluation after testing is determining the probable cause, whether or not there’s medical or surgical treatment available, and if there is, how acceptable the effort, time course, risks, probability of improvement, and costs are to you.

I’m amazed at musicians who analyze and anguish over TI vs Chromes but do no more than a simple, basic hearing test (which is often free) and go for the least expensive hearing aids they can find without ever seeing an ear physician. We’re back at the teeth vs hearing analogy. Both are complex, wonderful to have, and fleeting if not protected. You only have to take the best care of the body parts and functions that you want to keep.

[wintermoon]

My hearing is pretty bad, especially in my left ear.
I worked a woodworking day gig for 40 years and though I wore earplugs I'm sure the table saws, vacuums and other machinery didn't help.
And I moonlighted as a musician playing in Hammon organ bands w a guy that put a huge Peavey amp on top of his Leslie.
The Peavey was about 2 feet from the back of my head, we always seemed to work in joints w tight bandstands so there was really nowhere else for me to stand. That Peavey really screwed up my hearing to the point when I had an exam the doctor just shook her head looking at the results.

[Woody Sound]

My hearing is pretty bad, especially in my left ear.

I always liked the amp on my left, and in my 60's now I do notice that that ear is worse.

[MorrisGilliam1]

Pretty good